Provider Demographics
NPI:1851969042
Name:DAVILA, CHRISTIAN DANIEL (DDS)
Entity Type:Individual
Prefix:DR
First Name:CHRISTIAN
Middle Name:DANIEL
Last Name:DAVILA
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2612 SUNCREST VLG
Mailing Address - Street 2:
Mailing Address - City:MORGANTOWN
Mailing Address - State:WV
Mailing Address - Zip Code:26505-3843
Mailing Address - Country:US
Mailing Address - Phone:813-857-1909
Mailing Address - Fax:
Practice Address - Street 1:451 SUNCREST TOWN CENTRE DR
Practice Address - Street 2:
Practice Address - City:MORGANTOWN
Practice Address - State:WV
Practice Address - Zip Code:26505-1814
Practice Address - Country:US
Practice Address - Phone:304-293-5642
Practice Address - Fax:304-293-7649
Is Sole Proprietor?:No
Enumeration Date:2021-06-14
Last Update Date:2021-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program